'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

The centres are failing to attract anywhere near the target number of registered patients and – although many are proving successful as walk-in centres – some contract winners are calling for a rethink.

The revelation comes weeks after a Pulse investigation revealed how funding for Darzi centres was dwarfing that of GMS practices.

Dr Sunil Katecha, a GP running a centre in Solihull, West Midlands, claimed the massive majority of his patients were using it as a walk-in centre – as many as 100 a day – but that it was finding it ‘impossible' to hit targets for registered patients.

So far just 120 patients have registered, leaving it way behind the target for 5,000 by the end of its third year. He said: ‘This is ridiculous – we can't meet these targets. We've been running for three months and we're at 60%-70% capacity now.

‘I will have to renegotiate my walk-in contract because I can't continue to have the registered patients and the walk-in as well. We've told the PCT we do not think the numbers are realistic.'

Although overall funding for GP-led health centres is way higher than average practices – an average of £180.92 per registered patient in their first year – figures from 11 GP-led health centres show they are receiving an average of just £83.47 per unregistered patient in the first year, with the level scheduled to fall over following years.

Dr Peter Wilczynski, a GP running a centre in Corby, Northamptonshire, opened by health minister Phil Hope in December, said: ‘PCOs are going to have to think very hard about whether the investment they are putting into the eight-til-eight centres is viable.'

His centre has a target of around 6,000 registered patients by the fifth year of the contract but so far has signed up fewer than 400, although it has been seeing more than 1,000 walk-in patients a month.

Dr Wilczynski said: ‘Clearly, the predictions in terms of list size are not going to happen.'

A Department of Health spokesperson said: ‘We have never set any targets for the numbers of patients who should be registered.'

Dr Peter Wilczynski: ‘PCOs are going to have to think very hard about whether the investment they are putting into the eight-til-eight centres is viable.' Dr Peter Wilczynski: ‘PCOs are going to have to think very hard about whether the investment they are putting into the eight-til-eight centres is viable.'